Background: Lumbar radiculopathy caused by disc herniation is frequently accompanied by pain, functional disability, and impairments in sensorimotor control, including reduced proprioception and altered motor control. Interventions that integrate neural and mechanical components may enhance rehabilitation outcomes beyond exercise alone. Objectives: To investigate the effects of manual therapy combined with neurodynamic exercise and motor control exercise (MTN) with motor control exercise alone (MCE) on lumbar proprioception, motor control, and functional disability in patients with lumbar radiculopathy. Design: Randomized, single-blind clinical trial. Methods: Thirty patients with lumbar radiculopathy due to L4–S1 disc herniation were randomly assigned to either the MTN group or the MCE group. Both groups participated in supervised interventions three times per week for six weeks. The MTN group received lumbar joint mobilization and slider-based neurodynamic mobilization integrated with motor control exercise, whereas the MCE group performed motor control exercise only. Lumbar proprioception was assessed using joint position error during trunk flexion and extension. Motor control was evaluated using pressure biofeedback–based abdominal drawing- in performance. Functional disability was assessed using the Korean version of the Oswestry Disability Index. Outcomes were measured at baseline and during follow-up. Results: Significant group-by-time effects were observed for lumbar joint position error, motor control outcomes, and functional disability. The MTN group demonstrated earlier and greater improvements across all outcome measures compared with the MCE group, whereas improvements in the MCE group were more gradual. Conclusion: Compared with motor control exercise alone, the addition of manual therapy and neurodynamic exercise resulted in superior improvements in lumbar proprioception, motor control, and functional disability. An integrated MTN approach may be an effective rehabilitation strategy for patients with lumbar radiculopathy.

목적 : 본 연구의 목적은 ICF(International Classification of Functioning, Disability and Health)의 능력(capacity)과 수행(performance) 평가치의 신뢰도와 FIM(Functional Independence Measure)과 MBI(Modified Barthel Index)와의 기준관련타당도를 알아보고자 하였다. 연구 방법 : 국립재활원에 입원한 아급성기 뇌졸중 환자 55명을 대상으로 실시하였다. ICF에 경험이 있는 2명의 의사가 FIM과 MBI에 해당하는 항목을 ICF 항목과 연결시켜 10개 항목 중 3개의 범주인 이동, 보행, 자기 관리 항목을 추출하였으며, 모든 평가는 물리치료사, 작업치료사에 의해 수행되었다. ICF의 수행과 능력 평가치의 측정자간 신뢰도(Inter-rater reliability)는 급간내상관계수인 ICC(2.1)을 절대적 신뢰도는 SEM(Standard Error Measurement)과 SRD(Small Reference Difference)를 FIM과 MBI, ICF와의 상관관계는 Pearson 상관계수를 이용하여 분석하였다. 결과 : ICF 능력과 수행 평가치의 측정자간 신뢰도는 각각 .92(.95, .97), .98(.97, .99), SEM은 1.03, 1.09이었으며, SRD는 2.85, 3.02로 매우 높은 신뢰도를 보였다. ICF 능력 평가치는 FIM(r=-.97), MBI(r=-.90)와 높은 음의 상관관계가 있었고, ICF 수행 평가치는 FIM(r=-.73), MBI(r=-.69)와 중간 정도의 음의 상관관계가 있었다. 결론 : ICF는 FIM과 MBI의 기준 관련 타당도에서 음의 상관관계가 있었으며, 신뢰할만한 기능 평가 도구로서 뇌졸중 환자의 기능적 상태를 평가하는데 임상 연구나 실험에서 유용한 평가 도구가 될 수 있을 것이다.